Safety and Efficacy of Flexible Ureteroscopy in Combination with Holmium Laser Lithotripsy for the Treatment of Bilateral Upper Urinary Tract Calculi

Introduction: This single-centre, retrospective study aimed to assess the efficacy and safety of flexible ureteroscopy (FURS) combined with holmium laser lithotripsy in treating children with upper urinary tract stones. Methods: From June 2014 to October 2015, a total of 100 children (74 boys and 26 girls) with upper urinary tract stones were treated using FURS. A 4.7 Fr double-J stent was placed two weeks before operation. Patients were considered stone-free when the absence of residual fragments was observed on imaging studies. The preoperative, operative, and postoperative data of the patients were retrospectively analyzed. Results: A total of 100 pediatric patients with a mean age of 3.51±1.82 years underwent 131 FURS and holmium laser lithotripsy. Mean stone diameter was 1.49±0.92 cm. Average operation time was 30.8 minutes (range 15–60). The laser power was controlled between 18 and 32 W, and the energy maintained between 0.6 and 0.8 J at any time; laser frequency was controlled between 30 and 40 Hz. Complications were observed in 69 (69.0 %) patients and classified according to the Clavien system. Postoperative hematuria (Clavien I) occurred in 64 (64.0 %) patients. Postoperative urinary tract infection with fever (Clavien II) was observed in 8/113 (7.1%) patients. No ureteral perforation and mucosa avulsion occurred. The overall stone-free rate of single operation was 89/100 (89%). Stone diameter and staghorn calculi were significantly associated with stone-free rate. Conclusions: FURS and holmium laser lithotripsy is effective and safe in treating children with upper urinary tract stones.

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Outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi: a single center experience

10.22541/au.161962291.10436373/v1 ◽

2021 ◽

Author(s):

Wei Tao ◽

Ming Xu ◽

Yachen Zang ◽

Jin Zhu ◽

Boxin Xue ◽

...

Keyword(s):

Urinary Tract ◽

Upper Urinary Tract ◽

Laser Lithotripsy ◽

Flexible Ureteroscopy ◽

Successful Operation ◽

Stone Removal ◽

Single Center Experience ◽

Extracorporeal Shock Wave ◽

Urinary Tract Calculi ◽

Upper Urinary Tract Calculi

purpose: To evaluate the efficacy and safety of flexible ureteroscopy and laser lithotripsy(FURSL) for treatment of the upper urinary tract calculi. Methods: We retrospectively analyzed 784 patients who underwent FURSL between January 2015 to October 2020 in our unit. The operative parameters, postoperative functional outcomes and complications were recorded respectively. Rusults: All patients underwent successful operation. The mean operative time was 46.9±15.8min. The average postoperative hospital stay was 1.2±1.1 days. The postoperative serum creatinine and hemoglobin were 76.2±10.2umol/L and 133.6±5.1g/L, which compared to preoperative, there were no sigificant statistical difference. Among 784 patients, 746 patients were followed up and 38 patients were lost. 700(93.8%) cases met the stone removal critetia and 46 cases(6.2%) did not meet the stone removal criteria for other treatments, such as extracorporeal shock wave lithotripsy, ureteroscopy and observed regularly. The stone free rate(SFR) is 92.5% after 1-3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever(58/784,7.4%),gross hematuria(540/784,68.88%) and lpsilateral low back pain(47/784,5.99). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment. Conclusion: FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear,the complications are few and the safety is high. However there are certain limitation to the efficacy in the treatment of large stone and lower calyceal calculi.

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Development of the One-Surgeon Basketing Technique in Flexible Ureteroscopy with Laser Lithotripsy for Upper Urinary Tract Calculi

Videourology ◽

10.1089/vid.2018.0005 ◽

2018 ◽

Vol 32 (4) ◽

Cited By ~ 3

Author(s):

Shinsuke Okada ◽

Shuzo Hamamoto ◽

Takaaki Inoue ◽

Shingo Minagawa ◽

Hirofumi Morikawa ◽

...

Keyword(s):

Urinary Tract ◽

Upper Urinary Tract ◽

Laser Lithotripsy ◽

Flexible Ureteroscopy ◽

Urinary Tract Calculi ◽

The One ◽

Upper Urinary Tract Calculi

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The clinical outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi

Journal of X-Ray Science and Technology ◽

10.3233/xst-210992 ◽

2021 ◽

pp. 1-11

Author(s):

Wei Tao ◽

Xu Ming ◽

Yachen Zang ◽

Jin Zhu ◽

Yuanyuan Zhang ◽

...

Keyword(s):

Computed Tomography ◽

Urinary Tract ◽

Urine Analysis ◽

Intravenous Urography ◽

Upper Urinary Tract ◽

Laser Lithotripsy ◽

Flexible Ureteroscopy ◽

Stone Removal ◽

Urinary Tract Calculi ◽

Upper Urinary Tract Calculi

PURPOSE: To evaluate efficacy and safety of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi. METHODS: We retrospectively analyzed 784 patients who underwent FURSL between January 2015 and October 2020 in our unit. All patients were preoperatively evaluated with urine analysis, serum biochemistry, urinary ultrasonography, non-contrast computed tomography and intravenous urography. The procedure was considered as successful in patients with complete stone disappearance or fragments < 4 mm on B ultrasound or computed tomography. The operative parameters, postoperative outcomes and complications were recorded and analyzed respectively. RESULTS: The average operative time and postoperative hospital stay were 46.9±15.8 min and 1.2±1.1 days, respectively, among 784 patients. In addition, 746 patients were followed up and 38 patients were lost. In these patients, 700 (93.8%) cases met the stone removal criteria and 46 cases (6.2%) did not meet the stone removal criteria who need further treatment. The stone free rate (SFR) is 92.5%after 1–3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever (58/784, 7.4%), gross hematuria (540/784, 68.9%) and lpsilateral low back pain (47/784, 6.0%). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment. CONCLUSION: FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear. The complications are few and the safety is high. However, there are certain limitations to the efficacy in treating larger stone and lower calyceal calculi.

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